Qualified applicants are considered for the position(s) applied for
without regard to race, color, religion, sex, national origin, age,
citizenship, qualified disability, and ancestry or veteran status.
We are committed to a Diverse Workforce.

Have you ever previously been employed by any YMCA?Check the box for yes

If yes, when and where?

And in what position?

Skills:
Please list your special skills and/or training pertinent to this position

How did you hear about this position?

Activities:
Please list any community, extracurricular or professional activities (i.e: clubs or
associations) and any leadership experience or offices held.

Note: Under current federal
law, you are not required to list any organization which may indicate race, sex, religion or
national origin.

Have you ever been convicted of a misdemeanor or a felony?
NOTE:
Conviction of a crime will not be an automatic bar to employment or
volunteering. All circumstances will be considered in evaluating the
applicant's suitability for employment or volunteer status.

Misdemeanor

Felony

If yes, month/year

Please Explain

Current Employer or Reference

Phone

Address

Employment Dates

Supervisor

Starting/Ending Salary

Job Title/Description

Reason for Leaving

2. Employer or Reference

Phone

Address

Employment Dates

Supervisor

Starting/Ending Salary

Job Title/Description

Reason for Leaving

3. Employer or Reference

Phone

Address

Employment Dates

Supervisor

Starting/Ending Salary

Job Title/Description

Reason for Leaving

Graduate School

Name

Location

# of Years Completed

Did You Graduate?

Course of Study

College/Business-Trade or Tech

Name

Location

# of Years Completed

Did You Graduate?

Course of Study

High School or GED

Name

Location

# of Years Completed

Did You Graduate?

Course of Study

Training - Other

Name

Location

# of Years Completed

Did You Graduate?

Course of Study

Resume

You may optionally upload a resume in addition to your application.

I certify the above statements made in this application are true, correct and complete.
I understand and agree that any falsification or omission either on this form or in my
response to questions asked during the interviewing or examination process or on employment
forms I may subsequently complete, including “I-9” forms, may result in immediate termination
of employment, no matter when the falsification or omission is discovered.

I understand that this application will not be considered if not filled out completely.

It is understood that this application does not obligate the YMCA in any way and does not indicate any open positions.

I understand that the Akron Area YMCA is committed to
the YMCA Mission and acknowledge the core values of Caring, Honesty, Respect and Responsibility.

I understand that as an employee/volunteer of the Akron Area YMCA
I will be committing to the association’s Member Service Promise to be friendly,
attentive, and demonstrate caring, honesty, respect and responsibility while I am on
the job and/or volunteering for the association.

I understand that my signature constitutes my authorization for the Akron Area YMCA to
investigate the facts submitted and for those with relevant information, including, but
without limitation, physicians, hospitals, schools, law enforcement agencies, my prior
employers and/or personal references to provide such information to the Akron Area YMCA, and I
release them from liability for doing so.

I understand that a copy of this form shall serve as my authorization to release
information and records to the extent such information is job-related and consistent
with the Employer’s business needs. I hereby consent to undergo such drug screenings and
post-offer medical examinations as the Akron Area YMCA may require (which may include obtaining
body tissue or fluid samples and analysis of them).

I understand that, if hired, my employment is to be “at will” and that either I
or my employer may terminate my employment at any time, with or without cause,
unless the “at will” arrangement is modified by a written agreement signed by both
myself and the President of the Akron Area YMCA.

* I agree to the terms and conditions stated above

Welcome to All

A Safe Refuge of Hope

Regardless of race, religion, origin, sexual orientation, age or income -- the Y is truly open to ALL.

The Akron Area YMCA is a nonprofit organization whose mission is to put
Christian principles into practice through programs that build healthy spirit,
mind and body for all. The Akron Area YMCA is a registered 501(c)(3)
organization, Tax ID #34-0714727, and contributions are tax deductible.